title: A two-site hospital-based study on factors associated with nonadherence to highly active antiretroviral therapy.
abstract: OBJECTIVE
  To describe the pattern of adherence to Highly Active Antiretroviral therapy (HAART) and ascertain the factor(s) associated with nonadherence.
  
  
  METHODS
  This was a cross-sectional, two-site, hospital-based study. The study was undertaken in 2005; as a result of phased roll out of free HAART as part of National AIDS Control Program, patients at Lok Nayak Jai Prakash (LNJP) hospital were receiving free HAART, while patients at All India Institute of Medical Sciences (AIIMS) had to bear out-of-pocket expenses for HAART. Adherence was defined as not having missed even a single pill over the previous 4-day period on self-reporting.
  
  
  RESULTS
  Adherence at AIIMS was 47%, whereas it was 90% at LNJP. The difference was statistically significant. Multivariate analysis showed that nonadherence was associated with not having been told about the importance of HAART, having to pay out-of-pocket for HAART and reported continued risk behavior post HAART.
  
  
  CONCLUSIONS
  With the provision of free HAART, adherence is likely to be high. Emphasis should be given on simultaneous recruitment of counselors, and physicians should be made aware about the need to inquire and counsel patients against continued risk behavior.
authors.affiliation: Institute of Health Management Research, Jaipur, India. lal_vivek@rediffmail.com
authors.forename: Vivek
authors.initials: V
authors.lastname: Lal
authors.forename: Shashi
authors.initials: S
authors.lastname: Kant
authors.forename: Richa
authors.initials: R
authors.lastname: Dewan
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Rai
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Biswas
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D012307:Risk Factors; D011795:Surveys and Questionnaires